[Hormone replacement therapy, better aging, molecular genetic diagnostics and the image of the gynaecologist]

The benefit of hormone replacement therapy (HRT) for the treatment of menopausal symptoms is well accepted. In contrast, the debate about long-term consequences as a result of continued hormone replacement has recently been reactivated by the publication of results from the Women's Health Initiative Study. The concept of an improved identification of a risk profile of an individual patient based on molecular genetic diagnostics, while highly attractive sofar, has no solid scientific foundation. There is no evidence that by designing HRT on the basis of a specific gene profile of a particular patient the incidence of mild side-effects, which are fairly frequent,or of the rare severe complications can be reduced. Innovations in medicine require a convincing benefit-risk evaluation before they become part of routine practice, and a careful attitude of the physician towards new methods in diagnostics and therapy is a fundamental ethical requirement.